Patients with a poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle to mechanically raise a droopy eyelid Frontalis suspension procedure using a temporalis fascia or Tutoplast Dura was performed on 36 ptotic eyelids of 23 patients(age range 2-37 years) with a poor or absent levator function. The author used a surgical technique based on a modified Fox`s method. Satisfactory results were achieved in 42 lids according to the criteria of Jordan after an average follow-up of 23 months. No serious complication was seen immediately postoperative and during the follow-up period. Temporalis fascia and Tutoplast Dura appear to be effective and safe alternative sling materials for frontalis suspension surgery.
Blepharoptosis* ; Eyelids ; Fascia ; Follow-Up Studies ; Humans ; Jordan

Cavernous hemangiomas are one of the most common benign tumors of the orbit in adults. We report a case of a longstanding retrobulbar hemangioma that was removed successfully through a temporal transconjunctival approach combined with lateral canthotomy. A 45-year-old female patient, with a 15-year history of slowly progressive proptosis and decreased visual acuity of the left eye, had a corrected visual acuity of finger count at 50 cm OS, compared with 1.0 OD. Exophthalmometry by the Nagle's method measured 15 mm OD by 26 mm OS. Magnetic resonance imaging (MRI) revealed a well-encapsulated retrobulbar main mass, 2.3 x 3.0 x 3.7 cm in size along with multiple small satellite nodules that were displacing the optic nerve and globe superiorly. The tumors were removed through a superotemporal transconjunctival approach combined with lateral canthotomy. Pathological examination revealed an intraorbital cavernous hemangioma. The patient was free of visible scars, proptosis and any other noticeable complications at her last follow-up, 6 months after surgery.
Case Report ; Conjunctiva/surgery ; Female ; Hemangioma, Cavernous/pathology/*surgery ; Human ; Magnetic Resonance Imaging ; Middle Age ; Ophthalmologic Surgical Procedures/*methods ; Orbital Neoplasms/pathology/*surgery ; Treatment Outcome

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

Macrostomia, also called a transverse or lateral facial cleft, is a relatively rare malformation. Although many surgical procedures have been introduced, and no gold standard has yet been established. Moreover, most papers published in Korea were based on the results of the research conducted on the very limited number of patients, and for this reason its findings do not offer sufficient clinical reliability. We devised a modified commissuroplasty as follows: First, new commissure was placed 1 or 2mm inside when compared with the opposite side so that the commissure may not look longer than usual because of the scar on the side. Second, z-plasty of about 5mm was performed on the nasolabial fold to prevent the displacement of the new commissure on its lower part and avoid a continuation of a scar with the medial flap placed upward. We treated 32 cases of macrostomia from August 1, 1998 to July 1, 2002. We obtained relatively satisfactory clinical results by using this modified commissuroplasty. Based on our experience, we intend to present a clinical analysis and an operation technique of our own derived from the classic commissuroplasty, so that we may contribute to the diagnosis and treatment of the patients in the future.
Cicatrix ; Diagnosis ; Humans ; Korea ; Macrostomia* ; Nasolabial Fold

OBJECTIVES: The aim of this study was to identify the risk factors for tooth loss over three years, according to the number of pre-existing teeth, in middle and old aged people in a rural area. METHODS: This was a 3-year follow-up study including participants from KoGES-ARIRANG. Eight-hundred and fifty-five participants took part in both initial and follow-up oral examinations and surveys, conducted between 2010 and 2016. The number of existing teeth was determined through oral examination, and the subjects' sociodemographic characteristics, subjective periodontal statuses, and oral health behaviors were identified through oral questionnaires via 1:1 interviews. Chi-square analysis was used to compare tooth loss in participants with less than 20 pre-existing teeth to tooth loss in those with 20 or more pre-existing teeth. Multivariate logistic regression analyses were used to identify risk factors for tooth loss. RESULTS: Four-hundred and thirty-nine (51.4%) subjects lost more than one tooth over three years. After adjusting for demographic characteristics, subjective periodontal statuses, and oral health behaviors in subjects with 20 or more pre-existing teeth, the odds for tooth loss were as follows: 2.11 (1.42-3.14) times higher in people aged over 65 years compared to less than 65 years, 1.59 (1.06-2.38) times higher in those with a low (below elementary school) compared to high educational level, and 2.01 (1.33-3.02) times higher in those with a severe compared to normal subjective periodontal status. CONCLUSIONS: The risk of tooth loss was different in subjects with less than 20 pre-existing teeth compared to those with 20 or more pre-existing teeth. Therefore, the approach to prevent tooth loss should be different depending on the number of teeth present.
Cohort Studies* ; Diagnosis, Oral ; Follow-Up Studies ; Logistic Models ; Oral Health ; Risk Factors* ; Tooth Loss* ; Tooth*

Antimetabolites, 5-fluorouracil(5-FU) and mitomycin-C(MMC), are used to promote the success rate of the glaucoma filtration surgery(GFS). The authors observed and compared the duration of bleb formation and complications by slit-lamp biomicroscopy, and the inhibition of fibroblast proliferation and of fibrosis by light microscopy following GFS in 4 group rabbits. One hundred and twenty rabbits comprised in this study were divided into four groups; the first control group(I) was the balanced salt solution soaked group(BSS) during GFS, the second(II) was the 5-FU subconjunctival injected group(5-FU SC) after GFS, the third(III) was the 5-FU soaked group(5-FU) during GFS, and the fourth(IV) was the MMC soaked group(MMC) during GFS. For the maintenance of bleb formation, MMC, 5-FU SC, 5-FU and BSS group showed 0%, 26.7%, 16.7%, 100% at the 1 month after GFS, and 0%, 0%, 0%, 73.3% at the 2 months after GFS, respectively, which suggested that MMC group lasted longest. The inhibition of fibrosis and fibroblast proliferation became higher in the order of MMC, 5-FU, 5-FU SC, BSS group at 2 weeks after the surgery. At 3 months after GFS, there was no conspicuous statistic difference(P>0.05) between 5-FU SC and 5-FU group, but some differences(P<0.001) in the rest groups. From these results, we concluded that antimetabolites such as 5-FU and MMC could be used effectively in cases of poor prognosis of GFS. However, the dosage and application method of antimetabolites should be considered very carefully and further research will be necessary to find out the optimal dosage with minimum toxicity.
Antimetabolites ; Blister ; Fibroblasts ; Fibrosis ; Filtering Surgery* ; Filtration* ; Fluorouracil* ; Glaucoma* ; Microscopy ; Mitomycin* ; Prognosis ; Rabbits*

OBJECTIVES: The purpose of this study is to compare educational effects between traditional classroom instruction and video self-instruction (VSI) for cardiopulmonary resuscitation (CPR) in boy's high school students. METHODS: This study was carried out targeting totally 96 boy students(47 people for experimental group, 49 people for control group) in the second grade of high school where is located in G city of G province from July 9-10, 2009. The experimental group and control group were arbitrarily selected two classes in the second grade. One class was assigned to the experimental group. another class was assigned to the control group. The experimental group was educated with VSI for CPR. The control group was educated with traditional classroom instructions for CPR. The analysis was performed with SPSS WIN (version 12.0) program using frequency chi-square(chi2) test, independent samples t-test, and paired t-test. RESULTS: After instructions, the knowledge, attitude, self-confidence, and skill performance accuracy scores on CPR increased statistically in both group. The increases of self-confidence (2.40 +/- 0.73) and skill performance accuracy score (2.67 +/- 0.29) in the experiment group were significantly higher than those (2.01 +/- 0.96 and 2.54 +/- 0.31) in the control group, respectively. CONCLUSION: This study suggested that VSI was more effective than traditional classroom education for self-confidence and skill-performance accuracy in CPR. To confirm it, more studies are warranted.
Cardiopulmonary Resuscitation ; Humans

Many studies have reported structural or functional brain changes in patients with alcohol-dependence (ADPs). However, there has been an insufficient number of studies that were able to identify functional changes along with structural abnormalities in ADPs. Since neuronal cell death can lead to abnormal brain function, a multimodal approach combined with structural and functional studies is necessary to understand definitive neural mechanisms. Here, we explored regional difference in cortical thickness and their impact on functional connection along with clinical relevance. Fifteen male ADPs who have been diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) underwent highresolution T1 and resting-state functional magnetic resonance imaging (MRI) scans together with 15 male healthy controls (HCs). The acquired MRI data were post-processed using the Computational Anatomy Toolbox (CAT 12) and CONN-fMRI functional connectivity (FC) toolbox with Statistical Parametric Mapping (SPM 12). When compared with male HCs, the male ADPs showed significantly reduced cortical thickness in the left postcentral gyrus (PoCG), an area responsible for altered resting-state FC patterns in male ADPs. Statistically higher FCs in PoCG-cerebellum (Cb) and lower FCs in PoCG-supplementary motor area (SMA) were observed in male ADPs. In particular, the FCs with PoCG-Cb positively correlated with alcohol use disorders identification test (AUDIT) scores in male ADPs. Our findings suggest that the association of brain structural abnormalities and FC changes could be a characteristic difference in male ADPs. These findings can be useful in understanding the neural mechanisms associated with anatomical, functional and clinical features of individuals with alcoholism

“Poland’s syndrome” is a rare congenital disease whereby defects can accompany the chest, nipple, chest wall, and extremities on one side of the body. We diagnosed a 19-year-old male patient who presented to another hospital for a routine physical exam before enlisting in the military and was suspected of having a left brachial plexus injury. His chief complaint was the flatness of the left anterior chest wall without any significant functional inconvenience. Aplasia of the pectoralis minor and costosternal portion of the pectoralis major was observed through physical examination and computed tomography (CT). The patient was diagnosed with left-sided Poland’s syndrome without any limb abnormalities. Poland Syndrome should be highly considered in patients presenting with bilateral chest wall imbalance in the absence of with a recent traumatic history.